Chlamydia tests and how to take them correctly

Below will be listed all the known tests for chamydia infection. The following will be commented on by the author of this blog.

Blood tests:

Anti-Chlamydia - Antibody class to Chlamydia trachomatis, pneumoniae

Enzyme-linked immunosorbent assay (ELISA). Determination of antibodies (IgG, IgA, IgM) to chlamydia in the blood. These antibodies are produced by the body in response to infection. Antibodies to chlamydia are detected by interaction with special preparations containing chlamydia antigens that form a strong complex with antibodies, which can be detected in different ways. In addition to the usual scrapings, blood is also taken for ELISA analysis. The method not only detects the causative agent of the disease, but also informs at what stage of chlamydia is in acute or chronic. The first antibodies appear on the 10th-20th day of the disease. Then there are other antibodies, which can indicate to the doctor the chronic chlamydia, or re-infection, or the activation of poorly treated earlier chlamydia. But the accuracy of this test for chlamydia does not exceed 50%. This is due to the fact that antibodies to Chlamydia trachomatis can be detected in healthy people. The presence of antibodies may be due to a previous disease (“serologic scar”) or cross-reactions with respiratory chlamydia.

Swabs:

Immunofluorescence reaction (RIF)

Material taken from the urethra or cervical canal is stained with a special substance, then examined under a special microscope (called fluorescence microscope). If chlamydia are present, they glow like fireflies in the microscope lens. The accuracy of this method is up to 50%. The time for analysis is no more than an hour. Accuracy of 50% is the main disadvantage of the method. RIF analysis requires a very professional laboratory technician, to collect the material - a professional doctor, unprofessionalism reduces the quality of the method. The disadvantages of RIF is that the material to be analyzed must be a lot, and the disease - to be in an active stage. There are false positives, when instead of chlamydia highlighted staphylococci. Inaccuracy of the method adds and the fact that the results are interpreted through the eyes of the laboratory technician - this method is characterized by high subjectivity of the result.

Microscopic analysis (general smear, bacterial culture)

In this type of examination, men are swabbed from the urethra, women - swabs simultaneously from the vagina, cervix and external opening of the urethra. This is one of the oldest methods, but it has not lost its importance. The smear is attractive because it is inexpensive, and in many public polyclinics it is done for free. But the probability of detecting chlamydial infection in this way is very low, no more than 15%, as microscopic analysis can detect only the presence of inflammation. According to the results of the smear can at best only suspect the presence of chlamydia, because in chlamydia the number of leukocytes in the smear is very small or even does not exceed the norm.

Seeding for Chlamydia trachomatis with determination of sensitivity to antibiotics

Sow for Chlamydia (culture method) with determination of sensitivity to antibiotics. Of all the methods of diagnosis of chlamydia, this is the most expensive and time-consuming method - the results of the analysis have to wait several days. The method is quite accurate: if the analysis for chlamydia by culture gives a positive result, you can not doubt the presence of these bacteria in the body. The advantage of this analysis and that in the process of seeding is determined, from which antibiotic the infection in the patient will die. The essence of seeding is that the taken material is “sown” on a special medium. After some time, by the size and nature of the colony of microbes, you can judge what has grown. Seeding detects chlamydia in 70-90% of cases.

PCR qualitative determination

Polymerase chain reaction (PCR) method. This method today has the highest sensitivity and specificity - up to 100%. This is what many doctors claim. When using PCR, the DNA of bacteria is analyzed directly. The most popular method, on which all doctors are repulsed. Basically it is taking a urogenital scraping, in some centers can take blood and check PCR.

Extraction on cell culture of MсCoy cells

One of the best, but at the same time the most labor-intensive is the method of diagnosing chlamydia by isolating the pathogen on cell culture treated with various antimetabolites (“gold standard”). For this purpose, a sensitive cell culture treated with cycloheximide is usually used. The sensitivity of the culture method compared to PCR is 70-80%, but at the same time it is superior to molecular biological diagnostic methods in terms of specificity.

Comments from the blog author

At the moment, there are many techniques available to diagnose for chlamydia. But, unfortunately, not one of the methods can not give you a 100% guarantee. The same any and vaunted PCR methods, which supposedly gives 100% results, according to the statement of most doctors. For me it turned out to be a trap, because of which I lost precious time. I passed this analysis more than 10 times, following all the rules of passing, and it was always negative.

There are many reasons for this, improper sampling, poor sensitivity to a rare strain of chlamydia, lack of infection at the site of sampling, for example it may be in the prostate and you have a scraping from the urethra of the penis.


But one of the main reasons why PCR will never show a chronic chlamydia infection is because PCR uses the DNA of the chlamydia to analyze. If you were treated incorrectly, or during asymptomatic chlamydia that you didn't even know you had, you were treated for other illnesses, like the common cold, where you were given a different group of antibiotics used for infections of the ENT organs. And many antibiotics affect the DNA of bacteria, destroying my DNA and that's why PCR will not see anything. Antibiotic resistance appears for the same reasons.

Antibiotic resistance
You have to remember that bacteria develop resistance to antibiotics.

In simple words, resistance appears if you do not treat something (instead of 10 days of antibiotic therapy, 8 days, because the symptoms have passed, but in fact the infection is still there) or to treat incorrectly, to drink antibiotics of the wrong group.

The first and most obvious mechanism of resistance is mutation of genes (DNA), which encode the antibiotic target, that is, in the place where the antibiotic was binding, there is another structure, slightly changed, and the antibiotic can not bind, so mutations in the active center of the molecular machine will reduce the effectiveness of antibiotics.

There is another mechanism of resistance, which is the synthesis of pump enzymes that either actively pump the antibiotic out of the bacterial cell, or cut it up, or attach something unnecessary to it, or modify the target of the antibiotic by inserting another chemical group into it so that the space is occupied and the antibiotic can no longer bind.


As for PCR, I believe that this method works well only in acute chlamydia where all symptoms are clearly expressed, or when the infection has not been more than 2 weeks. The most appropriate course of action is to take all available tests and be sure to
Allocation on the culture of cells MсCoy Since this method detects the most neglected and chronic forms of chlamydia. Many doctors are ambivalent about this method and do not even believe in it. Others say that it is the gold standard. In my practice, only this method showed the presence of infection in me. Do not forget that everyone carries a certain stamp of infection (everyone has different chlamydia), what stamp you have no one knows, there is little research in this area of medicine, it is a complex bacteria.